Prolapsed rectum: living with it versus surgery

Posted by ejoy @ejoy, Apr 24, 2023

In December of 2018 I had a full hysterectomy at the recommendation of my GYN. That is another story but important to this post. In 2019 I started having a bulge protrude from my rectum and I thought it was a hemorrhoid. I started self treatment to no avail. I finally saw a GI doctor and was told I had a prolapsed rectum. I had multiple tests performed on my bladder and rectum (just awful) which were all normal. They could not see any link between the hysterectomy and my current issue. (This was the same healthcare system so I am guessing it was in their best interest not to find a link.)

So my question is does any other member have this condition and what is / was your solution? The surgery sounds horrible, the doctor said it is sometimes not 100% effective. 95% of the time it will retract when urinating or having a bowel movement. My greatest frustration is when taking long walks or hiking it and any fecal matter starts coming out.

I am 68 yo and don’t know whether to live with it and only do surgery if it becomes 0% retractable, which could mean being at an advanced age and not healing as well, or do the surgery now while in good health and healing would be easier.

Interested in more discussions like this? Go to the Digestive Health Support Group.

Teresa, Volunteer Mentor | @hopeful33250 | May 29 7:41am

In reply to @laurette04 "Hi ejoy, I have the same question as you…. Soon I will see a specialist… Thanks..." + (show)

Hello @laurette04 and welcome to Mayo Connect. I see that you had a comment for @ejoy. In the meantime, you might find the following discussion helpful to you before meeting with the surgeon,
--Keys to a Successful Doctor's Appointment
https://connect.mayoclinic.org/discussion/keys-to-a-successful-doctors-appointment/

In the first post there is a video that you might find helpful.

I hope that this information will help you approach your appointment with a bit more confidence and a list of questions and concerns that you can address with the doctor.

I look forward to hearing back from you. Is your appointment coming up in the near future?

ejoy | @ejoy | May 29 10:14am

To those that have a prolapsed rectum. I have now learned that the advice from Dr Kevin Kasten at Atrium Healthcare in Charlotte, NC to “live with it” was the worst advice a doctor could give. I followed his advice and lived with it. I lived with it until I could not walk without difficulty.

I saw Dr Laura Altom UNC Rex Hospital in Raleigh, NC and was told it should have been repaired immediately. I had a rectoplexy 4/3/24 which was done by suspension, not mesh. Because I went so long without repair I have damage to my interior anal sphincters and nerves. So now physical therapy to try to retrain my body. If the PT is not successful, then another surgery.

So please do not put off surgery. Fecal incontinence is not fun.

researchmaven | @researchmaven | May 30 10:52pm

In reply to @laurette04 "I’ve had a prolapsed rectum for many years…. I too didn’t know what it was…there is..." + (show)

I have some of what you have, but my prolapsed rectum is internal.

I was told, no coughing, no straining and no constipation could keep it from getting worse.

I eat the right foods (for me) and also take supplements so that I am not constipated.

When things go awry and I am constipated in the lower rectum due to the prolapse, I sit on a firm chair a special way to "contract" my internal prolapse. This induces a bowel movement. I do itthis way:

On a firm/hard chair, I sit on my left butt cheek only (leaning farther over to the left) and cross my right thigh over my left thigh, above the knee (leaning into it). Having a fullish belly (hot drink, hot cereal) helps too. The prolapse is pressed into a more normal constipation and I can clear the lodged stool.

This is an "engineering/plumbing" hack.

If I go down the surgery path at some point, I would only consider a Castle Connolly - listed surgeon for it. They are the best doctors. Researched. Listings cannot be bought. The company makes its money another way. Of course, there are non-listed excellent surgeons, but without an inside track on who those are, I will stick to this listing. It's never let me down.

Let us know how you are doing.